Manager, Revenue Operations (ROPS)

Billing Manager

This position manages the billing, third party insurance collections, and cash posting activities for multiple teams responsible for reimbursement operations and accounts receivable (A / R) for DaVita Rx pharmacies in accordance with company policies and in compliance with federal, state, and SOX regulations.

Supervisory responsibilities include full supervisory responsibility for recruitment, hiring, retention, performance development, performance management, teammate relations, salary adjustments, and termination of direct reports.

Essential duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive :

Manage work of teammates and participate as necessary to ensure goals are met within established policies and procedures

Manage the Third-Party Billing and Collections team to minimize Third-Party A / R

Manage the Cash Posting team to ensure all Third-Party (Insurance) and Patient payments are applied in accordance with company policies

Complete weekly reconciliation of payments received and posted to meet Cash Controls and SOX compliance requirements

Ensure patient billing statements are produced accurately and mailed timely each month

Manage the Medicare Part B Billing team to ensure billing and collecting on Medicare Part B items (as well as resulting secondary billable items) are completed timely, accurately, and in compliance with all laws and regulations

Participate in achieving pharmacy-wide goals including but not limited to Patient Retention and Quality initiatives

Review daily, weekly, and monthly key metrics to identify trends or areas of focus; inform Director of variances and trends

Maintain confidentiality of all patient, teammate, and company information in accordance with HIPAA regulations and DaVita policies

Collaborate closely and in conjunction with Director with other DaVita Rx departments and teammates as well as with DaVita facility teammates as necessary for the overall benefit of patients and achievement of mutual goals

Maintain current knowledge of all laws, regulations, and changes that may impact the Reimbursement Operations team

Travel Required : up to 10%

Teammate Management

Provide leadership to direct reports

Help direct reports overcome any organizational obstacles encountered during projects

Manage all teammate employment activity such as hiring, promoting, job performance, evaluations, retention, and disciplinary actions with appropriate approvals as required

Address teammate relations issues appropriately and escalate as necessary

Develop, document and implement action plans, as appropriate, to address deficiencies identified while reviewing teammates' work product

Know, understand, implement, follow, and communicate to teammates all DaVita employment policies and procedures, awards, and other opportunities within company and foster a positive work environment

Ensure all DaVita employment processes are completed timely and in compliance with DaVita policy and any applicable laws including but not limited to ePCNs, Performance Development Reviews, teammate personnel file maintained, etc.

Facilitate teammate development (PDRs, coaching, mentoring, DaVita training, outside training); collaborate with direct reports to create professional development goals

Provide consistent, visible, and timely communication to team on team goals, objectives, progress toward goals and enable teammates to meet job responsibilities successfully

Maintain familiarity with and communicate to teammates DaVita programs impacting teammates (including but not limited to : Triple Crown, We Are Here, Tuition Reimbursement, Foundations, etc.)

Ensure new teammates receive the appropriate training, tools, system access, and support to effectively complete their duties, understand department, computer systems, their role, and company policies, procedures and compliance standards

Provide work direction for department teammates

Determine staffing plans that promote the most effective use of all teammates; provide adequate staffing levels and phone coverage for all hours of operations; ensure coverage during teammate absences

Know and understand basic wage and hour laws, federal, state and local laws and regulations, Medicare, and legislation affecting employment

Review and approve time cards of hourly direct reports for bi-weekly payroll

Track overtime, attendance, and PTO

Develop and conduct educational programs to keep teammates up-to-date on DaVita policies, new laws and regulations impacting work, and other information necessary to maintain teammates' knowledge of department processes and goals

Know, understand, follow, and implement DaVita safety and security policies and procedures

Minimum qualifications include :

Bachelor's degree in Business, Accounting, or related field required

Minimum of five (5) years experience managing Accounts Receivable (A / R) in a healthcare provider setting

Demonstrated, detailed knowledge of and managerial oversight for Medicare Part D, Medicare Part B, Medicaid and Commercial Insurance billing and collections activities for plans across multiple states required

Advanced computer skills and proficiency in MS Word, Excel, Access, and Visio required; intermediate proficiency with Outlook required; basic proficiency in PowerPoint preferred; prior experience using electronic billing system strongly required

Essential behaviors, skills, and attitudes required for success in this position include :

Commitment to and role model of DaVita's values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun with ability to demonstrate those positively and proactively to patients, teammates, management, physicians, and / or vendors (Village Service Partners) in everyday performance and interactions

Ability to manage multiple projects, deadlines, and priorities in a fast-paced, ever-changing and evolving work environment

Demonstrated ability to work effectively at both detail and big-picture levels

Strong analytical skills with the ability to seek out underlying assumptions through probing, questioning, and listening

Ability to proactively identify and analyze issues and to identify and implement solutions collaboratively

Analytical thinker with demonstrated ability to perform root cause analysis, prepare and implement action plans, and lead improvement initiatives

Strong customer service skills and commitment to service excellence

Demonstrated ability to think outside-the-box

Proven leadership skills and the ability to collaborate across functions

Strong understanding of business process; ability to maximize resources to accomplish key metrics

Demonstrated ability to create, refine, and manage new business processes

Strong written, verbal, and interpersonal communications skills including ability to listen attentive